How to prevent umbilical cord entanglement in late pregnancy

Written by Zhang Yin Xing
Obstetrics
Updated on January 08, 2025
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There are no effective prevention methods for nuchal cord, which is the most common form of umbilical cord entanglement where the cord wraps around the fetus's neck, limbs, or trunk. Nuchal cord occurs in 90% of these cases, frequently involving the cord wrapping around the neck once. This phenomenon can be observed in 20% of deliveries and is associated with factors such as an overly long umbilical cord, a small fetus, excessive amniotic fluid, and frequent fetal movements. An excessively long umbilical cord is mostly a physiological occurrence since the cord floats in the amniotic fluid and its actual length cannot be accurately measured, with no effective methods to prevent its occurrence. Excessive amniotic fluid and a small fetus are linked to certain pregnancy complications, such as diabetes-induced polyhydramnios and restricted fetal growth. Actively controlling blood sugar during pregnancy can prevent such issues. Frequent fetal movements are physiological for some pregnant women. Women who experience more frequent fetal movements throughout pregnancy are likely to encounter nuchal cord. Clinically, nuchal cord does not require special management unless it leads to obstructions in fetal descent, fetal distress, or variations in fetal heart rate. It does not impact delivery or fetal development.

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Written by Zhang Lu
Obstetrics
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What should be noted if the umbilical cord is wrapped around the neck once at 39 weeks of pregnancy?

At 39 weeks of pregnancy, finding a single loop of umbilical cord around the neck during an ultrasound should not be a concern; this condition is quite common among pregnant women and does not have a significant impact on the fetus, nor does it affect natural childbirth. At this time, the following aspects should be noted: First, attention should be paid to any abnormal fetal movements. If there is an increase or decrease in fetal movement, it is necessary to come to the hospital for an examination to rule out hypoxia. Second, be aware of signs of labor, including bloody show and contractions. If these conditions occur, you should come to the hospital promptly to await birth. Third, it is important to attend routine prenatal check-ups a week later. Do not overly focus on the cord around the neck, as it generally does not cause hypoxia or affect the method of childbirth.

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Written by Zhang Lu
Obstetrics
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What to do if the umbilical cord is wrapped around the neck once in late pregnancy?

During the late stages of pregnancy, a B-ultrasound might sometimes reveal that the fetus has the umbilical cord wrapped around its neck once. This condition is a physiological occurrence. Having the cord wrapped once around the neck does not cause intrauterine hypoxia or harm the growth and development of the fetus inside the womb. The vast majority of cases where the cord is wrapped are physiological, and whether the cord is wrapped around once or twice, there is no need for excessive worry. In the late stages of pregnancy, the most important thing when the cord is found wrapped around the neck is to monitor fetal movements. As long as the fetal movements are good, it indicates that the fetus is in a normal condition inside the womb. It is also important to keep up with regular prenatal check-ups to assess whether the fetal growth and development are normal. Additionally, it is not advised to take any action to intervene when the cord is wrapped around the neck, as neither adopting sleeping positions nor any other methods can release the cord from the neck. These methods are futile and sometimes might even harm the fetus.

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Written by Zhang Lu
Obstetrics
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Can placenta previa with the umbilical cord wrapped around the neck one time be delivered vaginally?

Placenta previa and umbilical cord around the neck are two relatively common clinical conditions during pregnancy, and they have different impacts on natural childbirth. First, having the umbilical cord wrapped around the neck once is a very normal physiological occurrence, and it generally does not affect the ability to have a natural childbirth in any situation. Therefore, from the perspective of the umbilical cord around the neck, it does not affect natural childbirth. Second, placenta previa refers to the lower edge of the placenta being close to the internal os of the cervix. Whether natural childbirth is possible mainly depends on the type of placenta previa. If it is a partial or central placenta previa, such conditions generally cannot proceed with natural childbirth, as they might cause significant bleeding, necessitating an elective cesarean section. However, in the case of marginal placenta previa, where there is still some distance between the lower edge of the placenta and the cervical os, attempting natural childbirth might be possible, provided that preparations for a cesarean section are in place.

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Written by Du Rui Xia
Obstetrics
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Can you exercise with the umbilical cord around the neck?

When a nuchal cord occurs, one should not have too much psychological burden, as it is a fairly common situation. The prognosis should be determined based on the specific circumstances of the nuchal cord, including the number of loops and the tightness of the loops. If the cord wraps around once or if there is a loose knot, appropriate activities can be undertaken. However, if the wrapping is tight, or if there are multiple loops, one should regularly visit the hospital for prenatal check-ups to understand the safety of the fetus in the womb. In such cases, it is necessary to reduce activities to avoid increasing the risk of nuchal cord complications, which could cause fetal hypoxia or even suffocation.

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Written by Zhao Su Min
Obstetrics
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How to correct the umbilical cord wrapped around the neck once?

The umbilical cord is wrapped around the neck once, and there is no way to correct it; it cannot be rectified by changing position or through medication. The umbilical cord being wrapped around the neck once can be due to the umbilical cord being relatively long, or the fetus having a large range of movement within the womb. During pregnancy, as the fetal movements change, it might wrap around twice or even three times, although it's also possible that there will be no wrapping of the umbilical cord around the neck by the end. There is no need to panic if the umbilical cord is wrapped around the neck once. Pay attention to fetal movements and attend regular prenatal check-ups. If there is an increase or decrease in fetal movements, it is important to visit the hospital promptly to have an ultrasound, listen to the fetal heartbeat, and check for any signs of fetal hypoxia. If fetal hypoxia is present, oxygen therapy should be administered, and pregnancy termination may be necessary if required.